While many studies have shown that sitting is bad for our bodies, most Americans are struggling to get enough movement into their day. In a new study, published in Mayo Clinic Proceedings, researchers found that the average person is getting less than two minutes of activity per day.

Researchers from the University of Alabama at Birmingham placed data sensors on 2,600 people to see how much activity they did throughout the day. They found that obese women averaged 11 seconds of vigorous activity (meaning a jog or brisk uphill walk) daily, while normal weight men and women exercised vigorously for less than two minutes a day.

When moderate exercise, like yoga or golf, were counted, normal weight men and women averaged closer to two and a half to four hours a week. For the healthy weight population, that's great news and in line with the recommended exercise. For the obese population, this shows once again that obese men and women are stuck in an unhealthy cycle of inactivity.

Think you're burning the same amount of calories from cleaning your house as you would going to the gym? Think again. According to a new study published in the BMC Public Health journal, most people overestimate the amount of calories they're burning during housework.

Researchers from the University of Ulster interviewed 4,563 adults about their weekly exercise habits. They found that nearly 43 percent of adults interviewed reported activity levels that met the UK minimum weekly standard of 150 minutes of moderate to vigorous exercise. Of the activity reported, nearly 36 percent was related to housework like vacuuming, cleaning, and gardening, and the people who counted housework as part of their weekly exercise were heavier than people who reported traditional exercise.

They also found that women were more likely to report housework as part of their physical activity, and, of the women interviewed, only 20 percent met the physical activity guidelines set by the UK.

According to the Compendium of Physical Activities Tracking Guide, you can get a small calorie burn from vacuuming (130 calories) and other activities, but traditional exercise like cycling can burn 400 calories in the same 30-minute span.

The bottom line: Don't count housework toward your weekly physical activity. You'll feel and perform better if you fit in the recommended physical activity by biking, walking, jogging, or doing other traditional fitness activities. Think of calories burned from housework as a bonus!

Women who read food labels typically weigh less than non-label readers, according to a new study in the journal Agricultural Economics [NYDailyNews.com].

Analyzing data from the U.S. Center for Disease Control’s annual National Health Interview Survey, researchers found that women who read food labels had a body mass index 1.49 points lower than women who didn’t read labels.

Researchers also found that smokers were less likely to read food labels than non-smokers, city-dwellers were more likely to read labels than people who live elsewhere, and 58 percent of men read food labels compared to 74 percent of women.

Although it’s clear that reading food labels can benefit your health, labels are often deceptive. Read “How to Make Sense of Food Labels” for tips to navigate the grocery store and decode food labels.

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While research has shown that working overtime can increase your stress and risk of depression, workers aren’t slowing down. Employees continue to work late and take work home, according to a new survey by Good Technology [HuffingtonPost.com].

In a survey of 1,000 employees, researchers found that 80 percent of people spend an average of seven extra hours a week (nearly one extra workday a week, 30 extra hours a month, and 365 extra hours a year) doing work-related activities after hours. The survey also found that:

68% of people read emails before 8 a.m.

50% of people check emails while in bed

40% of people are still doing work after 10 p.m.

57% read work emails during family time

38% read work emails at the dinner table

And we’re not only clocking in extra hours at home, nearly 60 percent of workers are also skipping their lunch hour and eating at their desks, according to a poll conducted by Birmingham’s Aston University [DailyMail.com]. This adds up to 128 hours of extra work or 16 extra days of work per year.

The take-away: While shutting off completely may not be feasible, take some time for yourself. Do an email check once in the evening (if absolutely necessary) and field only emergency calls. At the office, take a few water breaks, eat your sandwich in the café, or just find 10 or 15 minutes for yourself. You’ll come back refreshed and ready to take on the day.

This may not come as much of a surprise, but a new analysis by Carnegie Mellon University confirms that we’re more stressed than ever [USAToday.com].

Researchers analyzed data from more than 6,300 people using the Perceived Stress Scale, a tool that assesses the degree to which life situations are perceived as stressful. They found that stress has increased 18 percent for women and 24 percent for men since 1983. The highest levels of stress were among women, people with lower incomes, and those with less education. The study also found that stress decreases with age, so keep your head up—apparently there are more stress-free days ahead!

So what’s causing our stress? In addition to greater economic pressures, researchers say it’s also harder to turn off the stress-inducing noise around you. “Our culture fosters and thrives on sensory overload, which leads to stress overload,” says Anthony Slater, director of performance at Core Performance. “That’s why it’s important to break up the day with a training session, a group exercise class, or a walk around the office or the block. Exercising not only reduces stress in the body, but it makes us feel strong and empowered.”

Designed by Core Performance specialist Nick Anthony, the workout starts with 5 reps of the Elbow-to-Instep Lunge (a.k.a. "World's Greatest Stretch"). When you only have time for one stretch, this is it. Follow that up with eight to 10 reps of the remaining moves, resting less than one minute between movements. Complete a total of three sets, and perform this workout two to three times a week.

Caitlin Boyle was just in her early 20s when she reached what she calls her “healthy tipping point.” A friend challenged her to give up the college lifestyle of partying and not paying attention to nutrition. That motivated Boyle, now 28, to take up triathlon and other endurance sports. These days, she attracts about 1 million visitors a month to her website, HealthyTippingPoint.com, and inspired the national “Operation Beautiful” craze where women leave upbeat messages on post-it notes for others to find in restrooms, locker rooms, and other public places. Core Performance spoke to Boyle about her new book, Healthy Tipping Point, and what impact a simple change of mindset can have.

Core Performance: What is a healthy tipping point?

Caitlin Boyle: It’s when you kind of get out of the mindset that being healthy is a huge struggle where you’re always giving up something. Instead it’s something you strive for every day. People can have that healthy tipping point moment for a variety of reasons. For me it was figuring out that I needed to focus on actual health—not my appearance and not striving to fit a certain size or weight—and fueling my body and mind the way they deserve to be treated.

CP: How did Operation Beautiful come about?

CB: I was having a bad day while trying to make a career change. I had gone back to community college and was taking chemistry and it was killing me. I felt so stupid and started to fall back into a negative mindset. At one point, I looked in the mirror and said, “You’re so stupid.’ I reached into my bag, found a post-it note, wrote ‘you are beautiful” and stuck it on the mirror. I took a photo and blogged about it and it took off from there. That was three years ago and I’ve received 10,000 notes from all over the world. It’s a testament to the fact that people of all races, nationalities, and languages go through these same struggles and these positive messages on post-its make a big difference.

CP: You write for a mostly female audience. You’re also a runner. In recent years, we’ve seen a boom in women’s only running events, along with health-and-fitness blogs like yours that speak to women. What do you attribute that to?

CB: Women like rallying around each other when it comes to fitness because on a lot of levels we feel more comfortable that way and that’s why women’s races are so successful. There’s always an air of camaraderie and support. There’s something about the sisterhood. It does seem unique to women, but I think men have it to some degree as well.

CP: You write about the importance of the beginning and the end of the day. What makes that so crucial?

CB: I call the first hour the power hour. We all have a tendency to fall out of bed and into the immediate work routine of going, going, going. And that’s very stressful on the body. There are a couple of simple tweaks you can do to set the tone for a healthier day. First, drink a really big glass of water. It helps digestion and sets your hydration goal off to a good start. Do this for one week and you’ll notice a huge difference.

The last hour is the restorative hour where we should be winding down and getting ready for sleep. Instead, we tend to go, go, go until collapsing. I have a hard time turning my brain off at night and I find writing down three things I have to do the following day helps me wind down. Not only do I not forget those things, but it’s as if I’m taking them off my plate for the moment. That way they’re not weighing on me all night long. That simple act of writing it down for the next day can really help you relax at night and set a positive tone for the following day.

Losing weight through diet and exercise can help reduce the risk of cancer in women, according to a new study published in the journal Cancer Research.

An estimated one in three cancer deaths in the U.S. is related to inactivity and weight. Inflammation is one possible contributing factor.

Researchers split 400 women into three groups. One group followed a low-calorie diet, one exercised for 225 minutes a day, and one tried a combination of diet and exercise. They found that the women who dieted and exercised had the biggest decrease in inflammation markers—a 42 percent reduction in C-reactive protein, which rises when there is inflammation in the body, and a 24 percent reduction in Interleukin-6, a protein that regulates immunity.

Men are more likely than women to exercise on a daily basis, according to research published in the journal Preventive Medicine. In the study of 1,000 men and women, researchers found that men were nearly twice as active as women. Men got an average of 30 minutes of activity daily compared to 18 minutes for women.

A recent article in Forbes explored research by McKinsey & Company that found that women are more likely to burn out and less likely to climb the corporate ladder than men. One reason cited in the article is women's tendency to take fewer breaks.

The article referenced the Captivate Network's finding that men are 25 percent more likely to take personal breaks at work. This includes being seven percent more likely to walk, five percent more likely to eat lunch, and 35 percent more likely to take breaks to relax.

Athletes' Performance Director of Nutrition and Research Amanda Carlson-Phillips suggests the following strategies to help women balance their day.

Plan lunch once a week with a co-worker or friends to make sure you get out of the office for a bit.

Pack your purse with your favorite energy bar, a water bottle, and other snacks to make sure you have something to eat during the day.

Find 10 minutes a day to clear your mind, even if you just grab a drink from the cafeteria, make tea, or get a snack.

Now that you're expecting a baby, you're supposed to be eating for two, right? Not quite. Most pregnant women only need an extra 300 calories per day. However, women who are underweight or overweight should speak to their doctor about specific calorie needs. To help you fill your calorie quota without packing on unhealthy pounds, we've put together eight healthy 300-calorie snacks.

Fortified Cereal

The snack: 1/2 cup of Grape Nuts, 1/2 cup of 2% milkThe benefit: Fortified cereal contains 400 mcg of folic acid (of 600 mcg needed per day for pregnant women). The addition of milk to a fortified cereal provides a great source of protein, calcium, and vitamin D, which are all important for tissue and bone growth.

Oranges and Almonds

The snack: 1 large orange, 1 oz of almondsThe benefit: This combination is packed with fiber and healthy fat to help you feel fuller longer and give you a little energy boost. Oranges are also loaded with immune-boosting vitamin C and folate, and they have a high water content to help you stay hydrated.

Dried Fruit

The snack: 3 oz of dried apricots, cherries, and cranberriesThe benefit: Research has shown that dried fruit contains higher levels of folate, which is one of the key nutrients needed for building DNA and RNA. Dried fruits like apricots, cherries, and cranberries are packed with disease-fighting antioxidants.

Yogurt and Blueberries

The snack: 1 cup of yogurt, 1 cup of blueberriesThe benefit: This snack combination is a great source of protein, calcium, and antioxidants. Yogurt also contains healthy bacteria, which is important for a healthy digestive tract.

Carrots and Hummus

The snack: 10 medium baby carrots, 1/2 cup of hummusThe benefit: Hummus, which is composed of chickpeas, is an excellent source of folate and fiber. Dip carrots into hummus for an added crunch that is rich in vitamin A, which plays an active role in the growth of the baby's organs and central nervous system.

Triscuits with Turkey Slices

The snack: 1 serving of Triscuits, 3 oz of turkey slices The benefit: Top Triscuits with turkey for a quick snack option to increase your daily protein and healthy fat. Be sure to eat fresh turkey. Deli meat may be contaminated with foodbourne illnesses like salmonella that can cross through the placenta and lead to infection or blood poisoning.

Guacamole with Fresh-Cut Vegetables

The snack: 1/2 cup of avocado, 1 diced tomato, 10 medium baby carrotsThe benefit: While pregnant, moms need more vitamin C, vitamin K, folate, and fiber (all of which are found in avocados) to support the baby's growth. Add a little tomato and lime juice to flavor your guacamole treat.

Cottage Cheese and Fresh Fruit

The snack: 1/2 cup of 1% cottage cheese, 1 large orangeThe benefit: Cottage cheese is high in calcium and protein, which promotes bone and tissue growth. Mix 1% cottage cheese with fresh fruit that is high in vitamin C such as oranges, pineapple or strawberry. Vitamin C is rich in antioxidants that can help boost the immune system and helps moms avoid pregnancy-related dental problems like weak gums and gingivitis.

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Eating a balanced diet high in fruits, veggies, whole grains, lean proteins, and healthy fats is key to a healthy pregnancy. During pregnancy, it's even more important to get enough of certain nutrients for the benefit of mom and baby. We've compiled a list of the best foods to meet these needs. Plus, a cheat sheet for foods to avoid during pregnancy.

Folate

Folate, also called folic acid when taken in supplement form, is a water-soluble B vitamin found naturally in food and is needed for building DNA and RNA. Folate can help reduce the risk of brain defects like anencephaly and neural tube defects like spina bifida in babies. To offset these risks, pregnant women need 600 mcg of folate per day. Try these folate-rich foods:

1 small orange (30 mcg)

1 ounce peanuts (40 mcg)

1/2 cup sliced avocado (45 mcg)

1/2 cup broccoli (45 mcg)

4 spears asparagus (85 mcg)

1/2 cup spinach (100 mcg)

1 cup fortified cereal (400 mcg)

Calcium

Calcium helps promote strong, healthy bones for mom and baby. If a baby doesn't get enough calcium, then it will take it from the mom’s bones, which can lead to problems for mom later in life. Plus, it plays an important role in muscle and nerve development along with promoting a well functioning circulatory system. Pregnant women need 1,000 mg of calcium a day. Foods rich in calcium:

8 oz non-fat yogurt (415 mg)

8 oz skim milk (302 mg)

1 cup fortified orange juice (200-250 mg)

3 oz salmon (181 mg)

1 oz feta cheese (140 mg)

1 cup chickpeas (105 mg)

Iron

During pregnancy, the body needs to support its internal changes along with helping the baby develop his or her own blood supply. Iron helps boost immunity, prevent anemia, and aids in blood supply development—pregnant women increase their blood volume by almost 50 percent during pregnancy. Pregnant women need about 27 mg of iron per day. Iron-rich foods include:

3/4 cup fortified cereal (18 mg)

1 cup fortified oatmeal (10 mg)

1 cup kidney beans (5.2 mg)

3 ounces beef tenderloin (2.2 mg)

3 1/2 ounces light meat turkey (1.6 mg)

3 ounces chicken (1.3 mg)

1/2 cup spinach (1.0 mg)

Zinc

Zinc helps with the production of DNA, the development of the baby's organs, and supports the immune system. Pregnant women need 11 mg of zinc per day. Foods rich in zinc include:

3 oz of lean beef (8.9 mg)

1 chicken leg (2.7 mg)

1/2 cup baked beans (1.7 mg)

1 cup of fortified cereal (3.8 mg)

Protein

Eating high-protein foods promotes the baby's overall growth, and the amino acids in protein serve as building blocks for the baby's cells. Pregnant women need about 70 g of protein per day. Foods rich in protein include:

3oz chicken breast (27 g)

3 ounces sockeye salmon (18.8 g)

1 large egg (6 g)

1 cup skim milk (8 g)

1/2 cup 1% cottage cheese (14 g)

2 tablespoons peanut butter (8 g)

Foods to Avoid During Pregnancy

While it's important to eat a healthy, balanced diet during pregnancy, there are also foods to avoid. Here's a short list of some of the most common foods to avoid during pregnancy (consult your doctor for a full list).

Certain Types of Fish

Some fish may contain mercury, which can damage brain development and may affect the baby’s nervous system. Pregnant women should avoid eating shark, tuna, swordfish, smoked fish (lox, kippered fish), and any raw fish.

Hots dogs and deli meats may be contaminated with foodborne illnesses like Salmonella, Toxoplasma Gondii, Monocytogenes, and Listeria. If these illnesses get into the mother's body and cross through the placenta to the baby, they can lead to infection or blood poisoning, which can be fatal. In order to kill these illnesses, deli meat or hot dogs would have to be reheated until steaming.

Alcohol and Caffeine

Drinking alcohol and caffeinated products during pregnancy have been connected to low birth weight, miscarriages and abnormalities. Alcohol has been specifically linked to fetal alcohol syndrome, deformities, and heart problems, while caffeine may increase the baby's heart rate harming their overall health and development.

*Daily recommended values are from the American Dietetic Association. Nutrient content information is from the National Institutes of Health, Office of Dietary Supplements.

The Challenge

In high school, Megan Walsh thrived on the hard work and team camaraderie that volleyball, swimming, basketball, and soccer provided. To stay fit as an adult, she spent her free time hiking, rock climbing, and snowboarding.

As her career took off, Walsh had less and less time for fitness (sound familiar?), so she worked hard during the week in the office and used her weekends for working out and participating in races. In May 2008, Walsh was out on a training ride in preparation for an upcoming triathlon. As she was biking home, she was hit by a car.

Walsh suffered a dislocated and separated shoulder, a busted collarbone, torn wrist tendons, and tons of cuts and gashes. She spent the next six months recovering. During this time, she found herself living a sedentary lifestyle due to her injuries, and she coped with the stress by eating. She started gaining weight, but hoped to get fit again after she healed.

Toward the end of her recovery, Walsh's doctor recommended surgery to fix her collarbone, which hadn't healed as expected. Due to a pre-planned cross-country move, Walsh was forced to put off the surgery until April 2009. While not impossible to work out, she found movement unpleasant and painful.

"I had put on even more weight by the time of the surgery, and I knew that I was looking at six months of downtime post-surgery," said Walsh. "So I thought why bother trying to get fit when I'm going to be unable to work out again so soon."

By time she was given the go-ahead to start training again, Walsh was heavier than she’d ever been in her life. Embarrassed by the weight she'd gained and her deteriorating fitness level, she was ready to get back in shape and feel great.

Walsh started looking for a program that would keep her accountable, but she loved being coached and knew she needed a great trainer. She signed up for a boot camp-style class, but wanted something that could help her regain her fitness and make overhaul her nutrition habits.

The Results

Walsh enrolled in Core Performance’s three-month pilot program through her job at Intel. In February 2010, she started training and set her goal to lose 15-20 pounds during the program (with an overall weight loss goal of 50 pounds). Each day at lunchtime, Walsh headed to the fitness center for 40 minutes of strength training and 25 minutes of cardio.

In addition to her training with Core Performance, she ran regularly during the week and started training for a half marathon. “I started to feel stronger within the first few weeks, but it took a few months for the pounds to really start falling off,” said Walsh.

During her program, she also committed to taking control of her unhealthy eating habits. An emotional eater, Walsh often found herself indulging even when she wasn’t hungry. (Are you an emotional eater? Click here to learn more.) With the advice and guidance of her trainers, she started to eat clean, track her eating habits, and focus on eating only when she was hungry. With her eating habits under control, she started to see major changes.

“The stability of the Core Performance program and encouragement and support I got from the coaches was a source of personal strength for me,” said Walsh.

Within a year of committing to get healthy, Walsh has lowered her blood pressure and cholesterol, overcome her asthma, and decreased pain in her lower back and ankle. She's also dropped 60 pounds and five dress sizes.

“In one year, I went from vastly unhappy, overweight, and unfit, to running half marathons again,” said Walsh. “I’ve learned that diet is critical to weight loss and fitness, and I now listen to my body and balance my life by following the 80/20 rule.”

After overcoming her weight loss hurdles, Walsh has signed up for a few 10Ks and adventure races, including the Chicago Half Marathon this summer. Her goal is to complete all of the races and run the Chicago Half Marathon in 2:10—13 minutes faster than her personal record.

For more on Walsh's weight loss journey, watch the video below.

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Erin Kowal Downs recognizes that she’s the woman that makes many of her fellow new mothers envious. The 5-foot-3 nutritionist and triathlete gained just 21 pounds during her pregnancy before delivering her first child last November, less than two weeks after her 37th birthday. Between son Dylan’s healthy size (7 pounds, 15 ounces) and a quick return to training, Downs was back to her pre-pregnancy weight of 115 pounds not long after ringing in the New Year.

As a registered dietitian, Downs understands that women respond differently to pregnancy and not everyone will make such a smooth transition. “I’ve met many women over the years who say they ate like a pig while pregnant and that’s why they gained 60 pounds,” says Downs, who lives in Redington Beach, Fla., not far from Clearwater and St. Petersburg.

“For others, they gained weight regardless of what they ate. Everyone is different.” Downs has a triathlete friend who was pregnant at the same time, maintained an active training schedule, and still gained 60 pounds. So how did Downs, an Ironman finisher who has completed four Ironman 70.3 events, manage the weight during and after pregnancy? Here are her strategies:

1. Consider Calories

The general rule of thumb is that women need an extra 300 calories per day throughout their pregnancy. That’s significant, but not as many calories as many women assume. Three hundred calories adds up to about one additional snack.

Downs continued training up until birth, swimming in a pool the day before her son arrived two weeks early, boosting her calories from 1,800 to about 2,100. Of course, we’re not all triathletes so it’s important to go at your own pace, listen to your body, and adjust your calories accordingly. Had she dialed down her training significantly, Downs might have adjusted those numbers.

As for cravings, she experienced nothing unusual. “My craving for cottage cheese went from maybe every other day to twice a day. And I ate more nuts—cashews and almonds. But other than more dairy, I was fortunate in that I wasn’t craving anything unusual or unhealthy.”

Like a lot of new mothers, Downs discovered that breastfeeding jumpstarted the weight-loss process, even though it required her to take in additional calories. “That’s something that’s really important because exercise decreases milk production,” Downs says. “You really have to be in tune with your body on that.”

2. Maintain Your Fitness

Pregnancy is no time to start a new training regimen. At the same time, it’s not necessary to dial it back completely. Downs raced her last triathlon of 2010 in April, not knowing she was nine weeks pregnant.

Once she got the good news, she swapped her bicycle for a spin bike, kept running until she was seven months pregnant, and maintained her swimming routine. When she no longer could run, she substituted work on an elliptical machine. Swimming became her favorite exercise. “You’re so buoyant and it’s the only exercise where you feel normal,” she says.

Doctors told her to keep her heart rate under 160, which she did, but maintained a weekly schedule of six days training: two each of swimming, biking and running. “If you can exercise for at least 30 minutes a day during pregnancy, it’s going to help with delivery, decrease the chance of complications, and make for healthier babies,” Downs says. It also gives you more energy and helps relieve stress.

Remember: It doesn’t have to be an intense session to qualify as a workout. It’s amazing what a 30-minute walk will do for your energy and psyche. All those minutes add up over nine months.

3. Set Post-Pregnancy Goals

Downs stresses that she’s fortunate to have a good support system to assist with the newborn. She has two stepchildren, ages 12 and 14, who will help and when she returns to work at the end of February, a nanny will watch the little guy three days a week. Her husband will watch the baby on those mornings prior to the nanny’s arrival, giving the new mom time for early-morning training. Working at home two days a week also will provide some flexibility in her schedule.

Some doctors suggest waiting six weeks after childbirth before resuming a training routine, but Downs began after just one week. The plan is to return to triathlon in April and complete an Ironman 70.3 race this year.

“As an athlete I feel so in tune with my body,” she says. “I stated with spinning lightly and lifting weights. By week four I was running. Again, everyone is different, but if you focus on nutrition and training throughout, it becomes a lot easier to get back into routines.”

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Amber Monson glides through the air, twenty feet from the floor, suspended from the rafters by only two long strands of fabric. There is no safety net.

She wraps herself in intricate knots, stretching and twisting into seemingly impossible positions, then plunging toward the ground in a death-defying roll with the silk curling wildly through the air.

Known as “aerial silks,” it’s a mesmerizing combination of grace, core strength, flexibility, and athleticism right out of Cirque du Soleil.

Monson, a self-described adrenaline junkie and rock climber from Atlanta, took up silks several years ago when she found it difficult to get to the mountains regularly.

“You basically climb up the curtains and tie yourself in different ways and create these mesmerizing shapes,” says Monson, 28.

These days, she performs her routines at conventions, fashion shows, sporting events, and nightclub openings. She teaches classes and has developed a home version of the silks apparatus that can attach to a common eight-foot ceiling.

Rock climbing gave her a solid foundation for aerial silks, but the key she says is the Core Performance program she’s followed since receiving the Core Performance Essentials book as a gift more than three years ago.

“You have moves you do in silks that take a lot of core strength,” she says. “But there are muscles you need that you don’t necessarily build doing the actual aerial work.”

Because of the physical demands, a silks routine rarely lasts more than 10 minutes. The strain on the core, especially the hips, can be intense.

“The core training gives me the stomach muscles to be up there and lift my legs above my head and twist in various positions,” Monson says. “I’ve found an incredible amount of improvement, especially in my hips, when I’m doing the dramatic drops and catch myself in the various harnesses or catch on one leg. It pulls your hips out, so when I get back to the Core Performance routine, I can pull the hips back into place and it alleviates the pain and soreness.”

For her silks students, Monson has developed a hammock-like contraption that rests only a couple feet off the ground. She’s taken some of the physioball exercises from Core Performance Essentials and adapted them to the hammock.

Whether with the hammock or ball, it’s essential training for when she’s up on the silks.

“You’re taking exercises you’re used to doing vertically or horizontally and now you have a total 3D orbital axis,” she says. “You’re upside down and twisted and using core muscles you didn’t know were there. You’re in all of these hanging positions – sideways, tucked, backwards and upside down – and suddenly you flip into something else.”

Monson is dedicated to living a healthy lifestyle of nutrition, exercise, and mental fitness. A graduate of Georgia Tech, she’s an avid reader who does not own a television. She prefers endeavors such as rock climbing and aerial silks since they’re both physically and mentally challenging.

“With rock climbing, you have to overcome your fear of heights and decipher this puzzle of how you’re going to get up this wall,” she says. “All of that translates into aerial silks.”

Her work with silks has become a full-time endeavor, in part because of the economy. After college, she put her degree in industrial design to use by working on retail spaces for an environmental engineering company. That gave her the experience to launch a construction business, a casualty of the housing bust.

These days, she runs SkyGym, which offers classes in aerial silks and markets products to perform the routines. Women make up about 80 percent of her classes, which tend to attract those with experience in yoga, martial arts, ballet, and rock climbing.

The classes teach students to move their bodies through space in ways they never imagined while developing core strength and flexibility.

Men tend to think it’s easier than it looks. “They’ll get up there and wimp out,” she says. “It does tend to attract more women, but there is a lot of stuff that men can do well, especially the poses where you’re hanging on your arms and doing flying-type poses.”

The concept of aerial silks has been around for centuries but only popularized since the meteoric growth of Cirque du Soleil in the 1990s. The silks fabric is strong and flexible, but attractive and colorful. In areas where it’s set up permanently and pulled back when not in use, the silks can pass for draperies.

For Monson’s regular aerial silks routines, the fabric is attached to an I-beam from ceilings between 18 feet and 35 feet from the ground. Her performances have included a Monster Truck event, a New Year’s Eve nightclub opening - even a Mixed Martial Arts fight.

Not only did Monson demonstrate the same type of athleticism as the fighters but her graceful performance offered a stark contrast to men fighting.

“It adds to the mystique,” she says. “I come out and play with the silks on the ground and people think this is just a scarf performance. Then I wrap myself, my feet go off the ground and I go. You just keep building up the intensity.”

Monson has incorporated movements from Core Performance Endurance into her training and is beginning to work Core Peformance Women into her regimen as well.

“I’ll rotate them around, do some of them more or longer than others, but I don’t think I’ve taken any of them out,” she says. “It’s a major part of my training.”

To order Core Performance Women, visit any of the following Web sites:

Hip stability might be the number one issue facing women when it comes to injuries and ailments. Injuries of the anterior cruciate ligament (ACL) of the knee have reached epidemic proportions among young women, and not just athletes. Nobody can pinpoint a reason, with theories ranging from the increased physical nature of women’s sports to biomechanical issues to a possible tie-in to menstrual cycles.

ACL injuries lead to other knee problems, along with shin splints, stress fractures and other injuries. ACL injuries often are related to a lack of stability and mobility in the hips; the knee moves to compensate for the hip.

The hip cuff is the control unit for your lower body. It governs the thigh, which interacts with your knee and affects your foot position. The centrality of the hip cuff is why tremendous attention must be paid to strengthening the muscles in and around the area, as they are critical in controlling everything below your hips, and everything above as well.

The hip cuff consists of more than 40 muscles in and around your lower pelvis that are responsible for much of your lower body movement. Even if you think you already have the ultimate hip-and-glute workout routine, I assure you that you haven’t come close to addressing this key area.

Hips are the most overlooked area when it comes to decreasing the potential for injury. Most back and hip problems occur because of improper mobility and stability and faulty utilization of the hips. Most people are locked down or unstable in their hips. If one of your hip capsules is locked down, it’s as if one of your thighbones is welded to your pelvis—imagine wearing a permanent cast on your hip. To get anything to move, you would have to use excessive motion in your knees and back to make up for your hip’s immobility. The lower and middle back share some common responsibilities with your hips, but they were meant to be secondary, not primary, initiators of movement. By maximizing efficiency in and around the hip cuff through improved mobility, stability, and strength, you will discover the engine that will propel you throughout daily life, to say nothing of creating “buns of steel.”

We want to focus on becoming glute dominant instead of quad dominant. This is a key concept. Most women move from their knee joints as opposed to their hip joints; they’re “quad dominant.” Their knees move first, stimulating the quadriceps muscles to fire at the onset of movement. This is a dangerous thing because the hub of your wheel is your pelvic area—not the quads. You want to absorb force through the more powerful center of your body toward your glutes, which will enable the limbs to work together to produce force. To try to absorb this much force in the quads alone is to invite ACL and other leg injuries.

Imagine if you slip on a patch of ice. If your knees and quads move first, you’re probably going to fall, likely resulting in a knee injury. But if you can absorb that force through the center of your body and your glutes, you’re less likely to tumble and if you do, it’s less likely to produce a knee injury.

The reason women tend to be quad dominant is that they have a larger “Q angle,” the angle at which the femur (upper leg bone) meets the tibia (lower leg bone). Women’s hips are slightly wider relative to their knees and often a woman’s knees fall more toward the midline of the body, creating a greater angle from the knee to the hip.

This is the price women have to pay for being able to produce the miracle of childbirth. There’s nothing we can do to change this, obviously. But what you can do is be aware of it so that when you look in the mirror or watch your workout routine, your knees are not coming together and definitely not rubbing together.

The Core Performance program will help you develop more femoral control by focusing not on your knees but in your hip cuff, which is the control center for both your knees and lower legs. We’ll spend lots of time on movements that challenge the hip rotators. These exercises might feel like butt busters but are actually knee and back protectors, giving your body the ability to control the angles and better disperse force into your muscular system.

I hail from Sequim, Washington, not far from the headquarters of Costco Wholesale, the popular warehouse shopping company that sells everything from electronics to clothes, books to wine, furniture to tires and, of course, food.

There’s a misperception about Costco and its competitors that they only sell food in bulk sizes fit for a family of twelve. Actually many items in warehouse stores are the same size you might find in grocery stores, at a fraction of the cost.

I’m a big fan of Costco, especially its commitment to customer service and providing quality merchandise at affordable prices. My coauthor Pete Williams, however, has reached the point where he rarely shops anywhere else. Talk about keeping life simple.

Here’s a look at how to simplify your nutrition planning.

Rotisserie chicken: These are an excellent value at $5.99. Remove the fatty skin and you have enough for one meal plus leftovers. If you buy two, you can carve the second one up and take care of several lunches and perhaps another dinner. Other great protein sources available at Costco include eggs and cottage cheese.

Flank steak: This is the leanest cut of beef, yet it’s juicy and flavorful. Costco portions aren’t small, but if you’re cooking for only one or two, you can freeze half of it.

Wild salmon: It’s sometimes difficult to find salmon that’s not farm-raised, which contains higher levels of chlorinated compounds known as polychlorinated biphenyls (PCBs). Costco sells wild salmon, some of which is already marinated.

Vegetables: Go for the mixed dark greens available in boxes or bags. Organic spinach comes in large bags or plastic tubs with a short-term expiration date. Spinach is versatile—you can use it to anchor salads or cook it in olive oil and serve as a side dish for dinner. Asparagus and broccoli come in larger packages and can be enjoyed several times over the course of the week. At our house asparagus is considered finger food.

Berries: Berries are one of the best sources of antioxidants and they provide flavor as an oatmeal topping or part of a dessert. The price of blueberries fluctuates wildly over the course of the year, depending on whether Costco can obtain them from local farmers or must ship them from greater distances. You usually can find blackberries and strawberries as well. Frozen berries are always a good option.

Olive oil: This can be a bigger-ticket item, so it pays to buy in bulk. Costco’s private-label “Kirkland” extra virgin olive oil is a good value and a rich source of healthy fats as a salad dressing or as a marinade for spinach and asparagus.

Tomatoes: Rich in antioxidants, tomatoes are a staple of any high-performance diet. Costco sells them in all sizes, from grape to full-size.

Oatmeal: There’s perhaps no simpler, better breakfast than old-fashioned Quaker oatmeal. Costco sells a large double-bag box that will last two months, even if you eat oatmeal every day for breakfast. Steel-cut oats is a terrific option, as well, and can sometimes be found at Costco.

Whey protein powder: Whey is a by-product of cheese manufacturing and includes many essential amino acids that boost the immune system and promote overall good health. Protein powder, such as EAS whey protein, can be found in chocolate and vanilla powder and can be mixed with oatmeal to give your breakfast some potent protein. It’s also good as part of a pre-workout shooter or mixed with berries as a smoothie.

Nuts: They’re not cheap, so it pays to buy in bulk. You can put them in salads, mix them into post-workout recovery shakes, and even eat them alone as a mid-afternoon snack to get some healthy fats. Almonds, walnuts, and pecans are good choices. Freeze to keep fresh.

Brown rice, whole wheat couscous, wholewheat pasta: Since we make this category a minor portion of Core Performance nutrition, you might be better served with smaller packages from the grocery store. Then again, these products do have a long shelf life.

Water: Costco sells bottled water by the case. Grab some standard half-liter bottles, along with some 8-ouncers for kids or guests who might not need a full bottle. Of course, you can save money and the environment by refilling your own water bottle.

Wine: Did you know that nobody sells more wine in the United States than Costco? Because of that buying power, the savings is passed along to you. Costco wines come from all over the world, including Europe, South America and Australia. Alcohol, even wine, should be kept in moderation, but there’s perhaps no better place to pick up a quality bottle of wine for a reasonable price. My favorite is pinot noir, but Costco has everything to satisfy your wine palate.

With just these thirteen items, you can feed yourself for a week. It’s not all you can eat, but it could account for more than 80 percent of your consumption, more than enough to keep yourself on budget and, more important, on track with the Core Performance nutrition program.

Researchers followed more than 3,000 older men and women for more than two and a half years, and they evaluated each participants' thigh muscle strength. To see if the participants developed osteoarthritis, the researchers took X-rays of the participants’ knees at the beginning and end of the study.

They also asked about pain, aching, or stiffness in the knees. By the end of the study, 48 of 680 men and 93 of 937 women developed osteoarthritis, however women with the strongest thighs had a significantly lower incidence of symptomatic, or painful, knee osteoarthritis. Unfortunately, the benefit wasn't seen in men.

Core Performance founder Mark Verstegen and noted author Pete Williams have written a new book together that’s geared specifically for women. Core Performance Women is slated to release December 24 (you can pre-order now), but we wanted to give you, our readers, a quick heads up today. Here’s a very brief summary of what you can expect:

For the first time ever, Verstegen tailors the Core Performance system specifically for women.

The book shows how to develop the right mindset for success, while presenting a targeted nutrition and workout plan to take every woman to the top of her game.

It delivers a focused approach to proper recovery and muscle regeneration, which helps you gain full advantage of your time in the gym and helps prevent injury and everyday aches and pains.

Verstegen offers his strategies for success, revealing his "non-diet" plan and simple rules for nutrition—even providing fast-food meal plans for women on the go.

The book is filled with powerful advice interwoven with inspiring vignettes of women who take charge of their health.

James Lyons would seem like an unlikely person to write a book on nutrition and exercise. After all, as a plastic surgeon, he’s often approached by people looking for quick-fix solutions after neglecting both areas.

But after spending nearly three decades as a surgeon, Lyons has developed an interesting perspective on fat. When working on patients who have adhered to a healthy lifestyle, he notices their fat is leaner and browner in color. Those who have followed poor diets and failed to exercise have yellow, “greasy” fat.

The book also offers some interesting perspectives on tissue quality, aging, and appearance applicable to anyone—not just those looking to go under the knife. Lyons advises patients to follow his program before resorting to plastic surgery. They might find they no longer need the surgery. He recently spoke to CorePerformance.com.

CorePerformance

What inspired you to write this book?

Dr. James Lyons

My perspective comes from being a plastic surgeon for more than 28 years and having the opportunity to go inside bodies. What defines my results is not just my expertise but the quality of tissue I’m working with. What I’ve found is that people who work out and eat well have distinctively different qualities of fat. They tend to have a different color and consistency of fat. Good fat is tan or brown. Bad fat is yellow, greasy, and loose, what I call “McDonald’s fat.” When you think about the aging process, it’s my belief that it’s quality of tissue and volume distribution that defines age in the body, especially with women.

CP: So the bad fat is literally yellow?

JL: Yes. People who are unhealthy have this yellow fat that’s not even cohesive. It’s like melted butter and it looks that color. It’s a bright, yellow, loose substance.

CP: What makes brown fat so valuable?

JL: With brown fat, the blood supply is good and it supports the skin and, most importantly, the muscles below. If you think of a woman with good brown fat, there’s a nice layer of fat over the muscles that accentuates what she does in the gym.

CP: Most women want as little fat as possible. Isn’t that the goal?

JL: Women work out for their bodies and not for their faces. If you do these drastic diets and cardio-shredding exercises, your body might be skinny, but your face looks like hell, ten to 15 years older than it is, and you’re running to me to put all of these fillers in your face. There is a way to make everything look more plump, natural, and beautiful and that comes from following a healthy eating program. The idea is to keep volume in all the tissues, including the fat. If you follow seesaw diets, you stretch the fascia, which holds the fat in position. Eventually the fascia becomes too loose to keep you looking youthful and you get that jowly look in your face. People understand how the skin is a reflection of how you’ve lived but that’s just the surface. If you change the quality of skin and the quality of fascia, you’ll look dramatically different.

CP: Is your work easier if you’re dealing with brown fat as opposed to yellow fat?

JL: Absolutely. Look, I love to do plastic surgery, but I only want to do it to people who will make me look good by giving me the best tissues possible to work with it. Think about trying to make a firm structure out of yellow fat; it’s not going to happen. I liken it to an ice sculptor who creates this beautiful piece and sets it out in 90-degree weather. That’s yellow fat. My work is not going to look good in six months.

CP: It almost sounds like if people follow your program, they’ll have less reason to do business with you.

JL: Not necessarily; I’m as busy as ever. But the thing I tell every patient is that they have to enlist themselves in the process. I’m not a magician. Studies have shown that people who undergo plastic surgery to fix some sort of psychological unhappiness feel the same way two years later. But if someone takes the time to enlist their body in the process, eating well and exercising and feeling that cerebral muscle connection that is so amazing, the results are unbelievable—physically and psychologically. It’s not just about going to the gym. It can be ballroom dancing, tennis, swimming—anything where you’ve shown that you’ve enlisted in the process. That makes my job much easier and your results so much better, whether we do business or not.

The Challenge

Vicky Arthur was a 13-year-old eighth grader when she received a copy of the original Core Performance book in 2004.

Back then, her sport of choice was rock climbing and she competed at a high level across the country. The Core Performance program helped her create the stability and mobility needed to excel in a demanding sport that requires both. As she advanced to high school, her focus turned to team sports and field hockey, where core conditioning was equally important.

“Your quads, hamstrings, and glutes take a beating in field hockey and if you don’t have that core stability, you’re not going to be very good,” she says. “You won’t be able to hit and shoot and you’re not going to be able to avoid ‘defensive tackles’ as we call them in field hockey. In terms of importance in the sport, core strength is second only to your overall ability and technique.”

Like many teenagers, Vicky does not spend much time thinking about what she eats, if only because she’s not the one purchasing groceries. Thankfully, the Core Performance program—and her parents—instilled in her healthy eating habits that prepared her for her freshman year of college at the University of Connecticut, where she plays field hockey.

The Results

Vicky is proud to be an early adapter of the Core Performance system, which helped her thrive in both high school and club field hockey. One of her club team’s trainers showed the team a copy of Core Performance and mentioned they’d be doing some of the exercises.

Vicky already was up to speed, having used the program to improve her game and attract scholarship offers from major Division I programs. It’s made her transition to college sports much easier.

“Core Performance has helped me at the D1 level by showing me the latest workout techniques which are all implemented in my lift sessions,” she says. “It has also increased my overall strength with is critical when playing field hockey because not only do you use your legs like soccer, but you use your arms when hitting the ball.”

She’ll likely avoid the notorious “freshman 15,” the extra pounds young women pack on once left on their own to eat for the first time. Having attended an all-girls high school, Vicky is well aware of the eating issues young women face.

“As an athlete, I’m fortunate to be around a group of girls who understand the idea of food as fuel,” she says. “But I see other girls who are not involved with sports constantly changing diets and worrying about body issues. Some of them are dealing with eating disorders and you wonder if it will get worse once they get to college. I feel like I’m prepared to make the right decisions.”

The Challenge

Kirsten Gross always had been an elite-level tennis player, first as a competitive junior player and later at Yale. But after graduating in 2000, she became immersed in the corporate world, earning an MBA at Southern Cal in 2007. Working long hours, she soon found herself 20 pounds heavier and feeling anything but like an athlete.

“I was just in what you’d call a rut,” she says. “I could not get myself motivated to work out or eat healthy.”

Where once she considered herself to have defined, muscular legs, she now simply had larger legs. She joined a prominent beach club that featured paddle tennis but went infrequently. When she did go, she felt sluggish and slow on the court.

In February, a friend asked her to accompany her to Core Performance Center. Gross went along for support, having no intention of embarking on a new program herself.

Her Results

Gross visited Core Performance Center on a Saturday and was immediately sold on the program. She began two days later, on Feb. 9, and transformed her body in six months, losing 20 pounds and significant body fat. She decreased her cholesterol, overhauled her nutrition plan, and began a routine of taking a multi-vitamin and fish oil for the first time ever.

Training at Core Performance Center (CPC) four days a week, she began to feel like an athlete again, especially when she’d hit the beach club and play paddle tennis. “A lot of them would say, ‘You look amazing. What have you been doing,’” she says. “I’ve referred a lot of them to CPC.”

Paddle tennis is played on a smaller court than tennis. The net is lower, the racquet is smaller, and the ball depressurized, but the skill set required is similar.

Before embarking on the Core Performance program, Gross occasionally would have shoulder problems playing paddle tennis, an ailment dating back to her time at Yale. By following the integrated system, the pain has gone away.

“I’m building all of the muscles instead of just playing tennis and bashing my shoulder,” she says.

The Core Performance program has given Gross her legs back, literally and figuratively. Paddle tennis colleagues have noticed that she can move around the court more. She’s lost inches around her waist and thighs, to the point where her clothes are too big. But she’s holding off on purchasing a new wardrobe because she still feels she’s not quite where she wants to be.

“I don’t want to spend the money yet because I know I can still go further,” she says. “But it’s already nice to have my pants loose around the legs. The big thing is that I consider myself an athlete again.”

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Congratulations to Christie Rampone, who just pulled off perhaps the ultimate soccer mom moment. Christie, the captain for Sky Blue FC, not only stepped into a player-coach role after the team's coach resigned, but then went on to lead her team to win the Women’s Professional Soccer Championship. Oh yeah, she was three months pregnant at the time.

Rampone, who has trained with Athletes' Performance, didn’t tell anyone about her pregnancy until after the final game. "They were getting a little annoyed I wasn't celebrating enough with them, with the cocktails," Rampone said on a conference call. "I hadn't told anybody. I said 'I'm almost three months pregnant. Eleven weeks.' Everyone was just shocked. It was an awesome moment to tell them." Read the full story at FanHouse.com

Football players may absorb insane amounts of physical harm, but those pom-pom wielding women on the sidelines are also facing a gut-check.

Between 1982 and 2007, there were 103 fatal, disabling or serious injuries recorded among female high school athletes, with almost 70 percent occurring in cheerleading. And cheer members accounted for 70.5 percent of catastrophic injuries among all female college sports.

Recent research in the journal Pediatrics looked at less severe injuries and also found alarming numbers. Children ages 5 to 18 admitted to hospitals for non-catastrophic cheerleading injuries in the United States jumped from 10,900 in 1990 to 22,900 in 2002.

The bottom line: Cheerleading is a sport. A highly physical one. If your daughter wants to cheer, encourage her to take her training seriously.

Swiss scientists analyzed the medical records of 683 people with lung cancer who had been referred to a lung cancer center between 2000 and 2005. Their conclusion: Female patients tended to be younger when they developed the disease, even though they were more likely to smoke significantly fewer cigarettes than men.

So help your loved one—or yourself—quit smoking (a family physician can prescribe a proper treatment). Because lighting up almost certainly leads to the grave—cigarettes cause 1 in 5 U.S. deaths.

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You know healthy eating is a must to look and feel your best for your wedding, but with so much on your mind, it's easy to skip meals and make poor food choices.

With the new Bridal Bootcamp at Core Performance Center in Santa Monica, California, brides work closely with our nutritionists to learn how to prep for their big day. Here's your chance to get in on the action. Avoid these four common mistakes that brides make in the weeks leading up to their "I dos."

1. Having Your Cake—and Eating it, Too

The Mistake: If your only "meals" are bites of red velvet cake, cupcakes and nibbles of "real" food at your tastings, then you're missing the mark. Yes, you want to look amazing in your gown, but not eating natural food often enough during the day actually slows down your metabolism. And, by the evening, you'll be so hungry that you'll have a harder time not overeating.The Fix: The key here is to "eat clean" for the next four weeks. Fill your diet with fresh fruits, veggies and whole grains in five to six small meals each day. By eating more frequently, you'll keep your metabolism charged, boost energy, and feel great.

2. Partying Pre-Wedding

The Mistake:The weeks leading up to your wedding are likely to be filled with parties in your honor: Bachelorette parties, bridal showers and a rehearsal dinner. While it's fun to get your friends and family together, this is a recipe for disaster. Those mini hor d'oeuvres aren't calorie-free and the cute cocktails are filled with sugar. A margarita can pack as many as 740 calories—yikes!The Fix:Instead of picking at the buffet all night, make yourself a plate and eat slowly. When it's time to hit the town, limit yourself to one or two drinks that are lower in calories, like wine. Research shows an occasional glass of white or red wine yields health benefits, and you'll be happier when you aren't bloated in your designer gown.

3. Late Nights

The Mistake: Yes, you have seating charts to make and favors to wrap, but don't let these last-minute details bring you down. Skipping out on the proper amount of shut eye not only makes you prone to making poor food choices, but it also increases irritability and focus. And nobody likes a bridezilla!The Fix: Set your party-planning projects aside, and hit the sack for seven to eight solid hours of sleep a night. Prep yourself for bed by relaxing, taking a warm bath and drinking some tea to wind down from your busy day. Can't seem to squeeze in enough sleep at night? Then at least learn the secrets to fast and effective power naps to help re-energize you during the day.

4. Lattes, Cokes and Pick-Me-Ups

The Mistake: If you're burning the midnight oil, stressing and not getting enough sleep, then you're likely making up for it with stops at Starbucks and bottles of Coke. Not only are you setting yourself up to get rundown, but not drinking enough water doesn't do your skin any favors either. Drinking plenty of water will make your skin look brighter and more radiant—perfect for your wedding day portraits (plus you'll save tons of calories at the end of the day).The Fix: Women should aim to drink 2.7 liters of water a day. To make it easy, purchase a reusable water bottle that's 16 ounces (about 1/2 a liter) or 32 ounces (equal to a liter), and fill it up throughout the day.

The researchers asked 13 women and 10 men about their favorite foods, which were a variety of dishes and desserts, including lasagna, pizza, brownies, ice cream and fried chicken. Then, after the study subjects fasted for 20 hours, the researchers presented them with those favorite snacks. The men and women were allowed to smell and taste the food but not eat it. Finally, they were told to try to inhibit their desire to eat the food. Subsequent scans showed that women’s brains were more active—or, hungry—during this period of self-restraint, leading them to cave into their cravings faster.

So, give your wife or girlfriend a break and don’t tempt them with treats.

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Overview

There are approximately 200,000 anterior cruciate ligament (ACL) injuries every year and between 80,000 to 100,000 involve partial or complete ligament tears. Yet more than half of them are self-inflicted. They involve no contact with another competitor, and they occur in a disproportionate number of female athletes—a problem that still persists though several new training programs have shown success in reducing the risk of injury.

Ligaments are structures made of tough, fibrous material that connect bones at joints. Of the four major ligaments that hold the knee joint in place, two of them—the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL)—are the ones most susceptible to stretches, partial tears and complete ruptures. The ACL, which is positioned in the front (anterior) part of the knee, is the smallest of the four knee ligaments, and is especially important for stabilizing the knee during sports activities. When it tears, recovery can be expensive, challenging, and time-consuming.

How ACL Injuries Happen

The ACL prevents the shin bone (tibia) below from sliding underneath the thighbone (femur) above. Without ligaments, the knee would be unstable and susceptible to frequent dislocation. The ACL can be stretched, torn, or completely severed when an athlete runs, decelerates, stops quickly, lands awkwardly after a jump, hyper-extends the knee, is off balance, or changes direction with the knee in a straight (extended) position. The exact cause is not clear, but it probably involves the way muscles function or fail to function, and each person’s anatomy. When an athlete does not have adequate muscle strength, coordination, or balance to quickly react to the demands of sports, there is an increased risk for a serious knee injury. Often times, glute weakness and instability lead to excessive strain being placed on the ACL, says Steve Smith, an Athletes' Performance physical therapist.

Female Athletes and ACL Injuries

One of the reasons why girls and women have higher rates of ACL injuries is because the angle from their pelvis to their knees to their feet is different from their male counterparts, says Joshua Hackel, MD, Director of Primary Care Sports Medicine, Andrews Institute, Gulf Breeze, Florida. "The angle creates increased stress on the ACL, which can lead to an injury," he says. But the risk of that injury can be reduced by a training program that develops hamstring strength and flexibility, pelvic strength and flexibility, and core stabilization. There is no age limit as to when these training programs should begin, Hackel says (and this applies to boys as well as girls). "As long as they are not maxing out on the amount of weight being lifted and as long as they are being supervised by an adult who is knowledgeable about proper technique, we think resistance training is a good thing for adolescents.”

ACL Injuries by the Numbers

70
Estimated percentage of ACL injuries that occur during the planting and cutting movements used in all sports

4-10
Girls and women sustain ACL injuries 4 to 10 times more frequently than boys and men in the same sports.

Who’s At Risk of ACL Injuries

ACL injuries occur up to ten times more frequently in girls and women than in boys and men, and are most common in women. Various theories exist, including a lack of balanced muscle strength between the quadriceps and hamstrings and inappropriate training for specific sports movements such as landing after a jump, stopping suddenly, or quickly changing directions.

Basketball and soccer players are at the top of the high-risk group, but volleyball players, gymnastics, cheerleaders, hockey players, wrestlers, rugby players, lacrosse players and skiers are not far behind. Football players suffer ACL damage in non-contact movements, as well as when they sustain blows to the knee.

Symptoms

Severe knee pain at the moment of the injury and more pain when you try to stand

A loud popping sound at the moment of the injury

Swelling that develops within 12 hours

Inability to bear weight—a feeling that your knee will “give way”

Arthritis (later in life)

Instability immediately after the injury, as well as later in life

Initial Treatment

Apply ice 15 to 20 minutes at a time, at least 3-4 times a day to control swelling.

Elevate the leg/knee above the level of the heart to minimize swelling.

Do not move the knee. Use a splint, elastic wrap, or crutches.

Use a pain reliever such as ibuprofen.

Do not try to “walk it off.” Those who do risk further injury to the joint.

If you think it is a serious knee injury, such as a torn ACL, see a doctor as soon as possible.

Comeback Strategy

The time needed to return to full sports competition ranges from six to nine months. Here are some things you can do to bridge the gap between your rehab and return to your sport:

Movement Prep

ACL Injuries and American Football

A study of elite-level running backs and wide receivers with ACL reconstructions showed that these athletes generally returned to their first game at 9 to 12 months following surgery. “Returning to football” is the point at which an athlete is ready to return to individual team practice. In a study published in the Journal of Orthopaedic & Sports Physical Therapy and authored by Mark Verstegen, Sue Falsone, Steve Smith and Russell Orr of Athletes’ Performance, the authors note: “Based on clinical experience, we feel that this milestone should be met 1 to 2 months prior to the athlete’s return to a competitive game. This means that rehabilitation efforts need to focus on returning players to practice and not just to the point of being able to performance train.”

“To determine if an athlete is ready to return to any movement-based sport, especially one that is a chaotic and involves violent collisions, the criteria or tests that are used should replicate the conditions as closely as possible. The criteria used to assess readiness should include position-specific, random movements that allow for bilateral comparison. Movement-based testing should be done with the athlete in a stressed or fatigued state. Because fatigue adversely affects motor control, it is important to see these potential problems in a controlled environment before placing the athlete back into such conditions under more random circumstances. Giving special consideration to fatigue is supported by the data from Bradley and colleagues, who reported that the majority of ACL injuries in the NFL that happened during games occurred later in the game.”

How to Reduce the Risk of Further Injury

Because a history of previous injury is the biggest risk factor for future injury, American football players who have undergone ACL reconstruction are more likely to be injured in the future. In the study mentioned earlier, the authors make several recommendations to reduce the risk of re-injury. “To lessen the risk, a high level of movement competency must be maintained through all stages of rehabilitation. Athletes must maintain a stable and mobile platform from which to move (a high level of pillar strength), so that excessive external forces inherent to the game do not unexpectedly create macrotrauma or even repetitive chronic microtrauma. One area that can easily influences is the athlete’s warm-up for both training and competition. We recommend that the warm-up be dynamic, weight bearing, proprioceptively rich, activate key stabilizers, and actively elongate/stretch the myofascial system.” This dynamic warm-up, or what we call Movement Prep, should be performed before every training session, practice, and game. Click here to see an example.

Jim Brown, Ph.D. has written 14 books on health, medicine, and sports. His articles have appeared in the Washington Post, New York Post, Sports Illustrated for Women and Better Homes & Gardens. He also writes for the Duke School of Medicine, UCLA School of Medicine, Cleveland Clinic and Steadman-Hawkins Research Foundation.

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As the first female physical therapist in Major League Baseball, Sue Falsone helps the Los Angeles Dodgers players avoid injury and stay in the game with the same methods used at Core Performance. In this video, she talks about what it feels like to make history, and what it takes to keep your muscles and joints strong and healthy.

Research published in the American Journal of Sports Medicine by researchers at the Santa Monica Orthopaedic and Sports Medicine Research Foundation, showed a 74 percent decrease in the number of ACL injuries to female soccer players who performed movements that improve pillar strength and neuromuscular control through the hips and torso (a.k.a. movement prep) compared to athletes who did not follow the program.

So replace your traditional warm-up with a series of dynamic movements, or movement prep. In addition to preparing your muscles for activity and boosting long-term mobility and stability, movement prep may help protect you from this horrific knee injury. Spending just 5 to 10 minutes on movement prep every day is a small investment for a body that's more resilient to injury.